Dr. Katharine Smart: Providing Healthcare is About Building Relationships

Podcast promo for episode 51, Dr. Katharine Smart. Pediatrician and past-President of the Canadian Medical Association. Whitehorse, Yukon

Being the former president of the Canadian Medical Association (CMA), a role she held during the height of the pandemic, has inspired Dr. Katharine Smart to be fearless and lean into the platform she was given to make an impact. 

Show Summary

Our guest Dr. Katharine Smart does it all - she’s a pediatrician working in Whitehorse, former Canadian Medical Association (CMA) president, the podcast host for Spark: Conversations, and holds a strong platform on social media. 

Through all her roles, her focus remains steady on advocating for kids’ health across Canada, holding the unwavering belief that all kids deserve the same opportunity to be healthy. 

Mentioned in this Episode

Transcript

Imagine you could step inside the minds of Canada's healthcare leaders, glimpse their greatest fears, strongest drivers and what makes them tick. Welcome to Healthcare Change Makers, a podcast where we talk to leaders about the joys and challenges of driving change and working with partners, to create the safest healthcare system.

Michelle Holden: Welcome to Healthcare Change Makers, a podcast produced by HIROC. I'm Michelle Holden here with Philip De Souza. Phillip and I are excited to bring you this latest interview with Dr. Katherine Smart, Dr. Smart is a pediatrician in Whitehorse before moving from the Alberta Children's Hospital in Calgary in 2018.

Many of our listeners will be familiar with Dr. Smart, not just for her role as president of the Canadian Medical Association from August 2021 to August 2022, but also for her distinct voice advocating for a stronger focus on kids health across the country. We also learn about Dr. Smart's self-diagnosis of excessive passion syndrome and find out a bit about what really drives her passion for safe care. Thanks for listening. Welcome Dr. Smart. Thanks for joining us on the show today.

Dr. Katharine Smart: Thank you so much for having me.

Michelle Holden: So we are recording this on the heels of the holiday season. Many parents just sending their kids back to school this week, sometimes a relief for some. Before we get into things, I just wanted to ask you kind of a simpler question, Dr. Smart, I want to ask you how you spent the holidays and whether you got some time to unwind.

Dr. Katharine Smart: I did, thank you. I had my family, my parents and my sister and her children and my family all together skiing, which was great. Unfortunately, we got caught up in some of the travel drama like everyone else. So there was some driving through the Rocky Mountains that was unplanned, but we all made it and it was great to be together. It was the first time in 12 years we were all together for Christmas, so it was a special time.

Michelle Holden: Oh wow. That is a big reunion and also a good time for it this year. So you're a pediatrician in Whitehorse by day. We know just kind of looking at your social media and where you are online that you're really all over the country delivering presentations and collaborating with others. So if it exists at all, what is a typical week for you?

Dr. Katharine Smart: Oh, that's a great question. It is really variable. A week for me can be anything from a week on service in the Yukon where I'm in my clinic and on call for the hospitals, we do sort of seven days in a row on service there 24/7. So those are always demanding but really rewarding weeks. And then the weeks I'm not doing clinical medicine, I'm doing a variety of other things.

So as you said, sometimes that's traveling to different parts of the country for conferences or speaking engagements or different sort of think take activities. Sometimes I'm hosting my own podcast, other times I'm working from home doing some consulting or just meetings. And then I'm on some different boards, so I do that type of work as well. So I think I'm pretty lucky to have a lot of variety in my life. And I never quite know what's coming the next month, so it keeps it interesting.

Michelle Holden: Yeah, that's really busy. Did you say that you host your own podcast?

Dr. Katharine Smart: I do. I'm the podcast host for Spark Conversations, which is a podcast with Children's Healthcare Canada, where we talk about different things in the health leadership space for pediatric health. So that's been a lot of fun for me this year.

Michelle Holden: Yeah. I've listened to that show before. Oh, that's great. And I'll definitely take a listen. So encourage all of our listeners as well to kind of check that one out from Children's Healthcare Canada. We met at the Children's Healthcare Canada conference this past November.

That's where I first got the chance to hear you speak. And delegates at that conference were talking a lot about creating a bright future for children's health. So I kind of wanted to ask you at this point what that means for you and what does that future look like?

Dr. Katharine Smart: Yeah, thanks for that question. That's a topic that's very near and dear to my heart. So I think what's really surprising and would surprise a lot of Canadians is just how wellbeing for children is not what you might think in a country as rich as Canada. So we rank 30th out of 38 similar countries globally for child wellbeing.

And I think there's many reasons for that, but I think one of the real challenges we have in our country is a lack of child focus policy across government initiatives. So we don't really step back and take that lens and look at how do different social policies impact children and where is the most bang for your buck in terms of creating that bright future for children.

So when I look forward ahead and what I think needs to happen over the next 10 to 20 years, I hope that we can start to really prioritize the wellbeing of children and for really two reasons. One, I obviously think it's the right thing to do. Obviously, I'm very passionate about children and their health. And from a moral perspective, I think kids all deserve the same opportunity to be healthy.

I think it's a huge equity issue. So I think we should be thinking about that. But if you even just want to be very practical about it, there's a huge economic benefit to childhood wellbeing as well. We know that adversity in childhood, adverse childhood experiences and trauma really impact that life trajectory of children.

And the more trauma children have in their childhood, the worse their health is going to be long-term, both physical health and mental health. So just even from a country perspective of economically what makes sense, having child-centric policies that really allow children to thrive is a very smart economic decision as well.

So I'm hoping that our government is going to start to see that, start to really center on what things can be done to make children's childhoods more positive in Canada. And that's really, I think addressing the upstream things that impact health, things like poverty, things like supporting families, early access to early childhood education.

And then of course in our health system itself, we really need to start right-sizing healthcare because we're struggling to meet the kids, the needs of children that have healthcare needs as well. So I think it's really looking at that question of why some people are healthy and others aren't and making sure that the healthcare system is there for children that need it.

Michelle Holden: That's a really good answer and sort of touches on some of the work that we know that you are doing right now, which is improving services for marginalized children. I'm just wondering if you can kind of tell us where that passion stems from.

Dr. Katharine Smart: Well, for me, it was really why I chose pediatrics as an area of medicine. When I was a medical student, I had the opportunity to spend some time working in South Africa at the Royal Children's Hospital there in Cape Town. And I also had the chance to work in the downtown east side as a student volunteer at a community clinic.

So those two experiences I think really got me thinking about the importance of children and their health, about the importance of social determinants of health, about what happens when our social safety nets fail people, when social programs are inadequate and sort of what we need to do to really help kids. And that also really developed my clinical interest in pediatrics, in the actual medicine of caring for children.

So that's where that for me really sort of started. And then as a pediatric resident, I had the opportunity to spend a month in Nunavut working. And from there, I started doing some work in northern Manitoba when I finished as a pediatrician. And that sort of all came together with this opportunity to move to the Yukon and create a child health program there.

So I think for me, that interest sort of started very early in my career and then I had a lot of different opportunities throughout my training and my work as a pediatrician to develop that interest. And then I was fortunate to have an opportunity to move to a place that needed a lot of work when it came to how to approach children's health. And I've been doing that work for the last five years and now have a big team that I work with. So it's been a really rewarding, I think to see that all come to fruition.

Michelle Holden: We know that making change, especially in the community does take time. So you said you've been there five years now. What do you see as some of the successes, the things that you've really gained traction on with that team?

Dr. Katharine Smart: I think the biggest success for us has been the relationship building. I really believe that providing healthcare is about building relationships. And again, especially in pediatrics where children are part of a broader community, you really need to have relationships with all the people around children to be able to really get at the different things that are going on for them in their life so that you can continue to augment the strength-based aspects of their life and make sure those things are supported and then get those right interventions in place for the things that are the challenges.

So we've put a lot of effort into building relationships, both with other service providers in the community that care for children. So things like teachers, the mental health programs, the child development center, other physicians, the communities, and the First Nations that are incredible in the Yukon in terms of the work that they're doing around family preservation and early intervention in childhood.

So we've spent a lot of time developing and building those relationships so people see us as someone they want on their team. And then the other piece of it's really been looking at what do we need to provide the services? So that's been growing the number of pediatricians, adding a social worker to our team, a child psychiatrist.

And then on the acute care side, we've done a lot of work in the hospital supporting nurses around caring for sick children and with emergency medical services to develop pediatric transport services as well because with the ongoing healthcare crisis, we are quite dependent on British Columbia to transport our critically ill children down to the children's hospital in Vancouver.

And over time, that access to that has really become limited. So we're having to provide that service ourselves. So we've also done that relationship and skill building with our local EMS who are already really skilled caring for sick adults to make sure that that full suite of services is available for children and babies and youth in the territory.

Michelle Holden: That's a lot of work. I know it sounds like you guys have made big headway, but are there some things that you're really focusing on for 2023, some things that you kind of want to keep doing, like that relationship building as you mentioned, obviously will keep going?

Dr. Katharine Smart: Yeah, absolutely. One of the key focuses for us I think is always thinking about who are we not seeing. So I think sometimes the myth a bit in Canada is because we have universal healthcare, that that means everyone's accessing care and that is certainly not the case.

When I first started working in the Yukon just over five years ago, that was one of the questions on my mind is who's not making it to the clinic to see me, who's not getting pediatric support who maybe would benefit from it? And that remains one of our questions.

So we're always looking at how can we continue to partner to make sure the kids that need our services are getting there? And that means also partnering with the government around things as simple as who can refer to a pediatrician. Traditionally in the healthcare system, specialists need referrals from family doctors, but of course as that primary care system is challenged with not enough providers and many people without a family doctor, things even as simple as that can be a barrier.

So it's also, "Hey, how can we work around that?" And we've been fortunate in the Yukon to also have a good relationship with government and they've been flexible about how people can refer to us, really allowing anyone to make a referral. So we continue to really relentlessly think about that question, who's not in our office? How can we reach people? How can we be better engaged in the community to make sure that all the kids who really could benefit from working with our team have that access?

Michelle Holden: That's a really good question, who are we not seeing? And I think across the country can kind of ask that question. It's really important to touch on not just where you are, but I'm really glad that you brought it up, Dr. Smart, you recently wrapped up your term in August as the president of the Canadian Medical Association, a role that you held during the height of the pandemic. I just wanted to know kind of what did you learn about yourself through that time, managing everything that you were?

Dr. Katharine Smart: Yeah, it was a really interesting experience. And I think the most interesting part of it really was that I had no idea I was going to be the president during the pandemic, because it's quite a long runway before you actually become the president of the CMA. And it starts with a year's president-elect and you find out about that, the results of that election even several months before that role starts.

So I actually had found out I'd won the election in the Yukon in February and the pandemic was declared in March. And then by the time I was in the role as the president, we were almost a year into it. So it was really interesting because of course it was not at all what I was expecting when I considered taking on this role. So it was certainly a lesson in having to pivot into uncertainty, that's for sure.

So I think what I learned about myself was a lot of things. I think one of the main things was not to be afraid, I think to step out and use the platform that you have. I felt very fortunate to be in that role during a very difficult time because it gave me an opportunity to try to use that role for positive change.

And for me, that meant really speaking out for my colleagues and what they were experiencing and bringing to light for Canadians, the stress that the healthcare system was under and just the realities of what people were dealing with. So I really appreciated the opportunity to do that. I really wanted to try to use the platform to educate Canadians.

I'm obviously very passionate about things like vaccination, that's such a fundamental aspect of the health of children. And now we were in a situation where vaccination was becoming a really critical for the whole population. So really trying to get good information out there to counter the misinformation that was challenging some Canadians to choose to be vaccinated.

So using the platform in that way. And then having the opportunity to be in the media and trying to use those experiences again to really make sure that Canadians knew what was going on, both with the pandemic but also more broadly in the healthcare system and some of the important changes that really need to happen to make our healthcare system sustainable.

So I think what I really learned ultimately was when you have a platform, if you're really willing to lean into it and just step into that opportunity, you can have an important impact. So it was interesting to do that. At times, it was certainly a bit uncomfortable. At times, you feel a bit stretched and worried, am I saying too much? Am I not saying enough? Am I being bold enough?

Am I being too bold? So finding that, kind of walking that path, it can be challenging. But it was certainly something that I enjoyed and I think my confidence around being in that space got better naturally as it would as the time went on. And at the end of all it, I just felt a lot of gratitude to have had that opportunity and what was and continues to be a really challenging time in our collective history.

Michelle Holden: Absolutely. And I really like what you said about pivot into uncertainty and kind of having to do that especially during the pandemic. But did you find it difficult at all sort of navigating how to advocate for both physicians and community and patients in that role? I know you mentioned doing both, but did you find that balance was hard to strike?

Dr. Katharine Smart: I think for me, I really believe that the right solutions have to benefit patients and providers. I don't think solutions that only are good for one of those groups are ever going to be sustainable or have the outcomes that we want to see. So in my mind, I think our interests are actually very aligned. Because things that are good for my patients and allow me to be healthy and thriving as a provider are going to be the right things.

So I really feel that when we talk about healthcare and the different issues that are going on, we need to always be trying to balance those two perspectives of how do we make this work for patients and how do we make it work for providers? So fundamentally, I think it's really about people. Because healthcare system really at the end of the day is about people on both of those sides.

So I really, when I'm looking at challenges or speaking to challenges, I really try to take that lens of, "Hey, where are we going here where both groups of people are going to feel like this is working out for them?" So in that way I think it makes it easier. But I think the risk of course is things are challenging is we can all start to retreat a bit into our silos and start to feel it's a bit us or them or sometimes it can be adversarial.

And I think right now it's of course, really difficult because the healthcare system is under so much strain that patients are really struggling. So often people can be quite angry and frustrated when they're trying to seek care and take that out on the provider in front of them even though it's not that person's fault that that's the situation. And that I think can sometimes put us at odds with each other, which is unfortunate because again, I think really what we want is the same thing.

And I know that no provider feels good when they know that they're not providing people with timely high quality care. So we have to, I think, be careful that we continue to be kind to each other, continue to treat each other with compassion and recognize that at the end of all this really our interests are the same.

Michelle Holden: While you're working hard as a pediatrician now, you're also being past CMA president and a mother of two, you still manage to grow your online platform. So you mentioned platform earlier, but I want to talk specifically about kind of social media platform, maintaining a really strong brand on there. So what advice would you give to someone in the healthcare field who might be trying to balance growing their career as a leader while also being their authentic self?

Dr. Katharine Smart: Yeah, thanks for that question. That was another sort of, I would say unexpected aspect for me of being the president was just how much I realized I needed to embrace social media and develop that online brand. Because right now what's really clear I think is so many people are getting their information online, both the public, but it was also a real way to connect with colleagues online as well.

So I think social media is here, it's here to stay. I think if you want to be a leader and especially a public facing leader, it's something that you've kind of got to embrace and it can be challenging. So in terms of advice around that, I think spend some time thinking about the brand that you want to create and the persona that you want to put out there.

What's I think challenging a bit with social media naturally is people see you there, they don't know you in real life, so they form their impression of you based on what you do and say in that space. And I think we've seen lots of different people show up quite differently in that space. And different personas work for different people, but I think you need to be thoughtful about what that is and it needs to be purposeful.

And I think whenever you're posting or the things that you're doing, you always need to sort of be reflecting, "Is this the persona I want to be putting out there? Is this the authentic version of me that I want people to be seeing?" Because naturally, sometimes those spaces can get a bit heated. I've certainly had lots of online attacks on social media from trolls, but also from other professionals if they don't like what you're saying. And that can be confronting.

And I think sometimes you have to kind of take a deep breath and press pause and again think, "How do I want to respond to this? What is the authentic version of myself I want to put out there? Do I want to be reactive or do I want to stop for a minute and really think, is this adding to the conversation or is this the way I want to present myself?"

So I think just being really thoughtful about it's important. Like anything in life, I think mentorship can be important. I think for someone who's new to those spaces, having trusted friends or colleagues who have some experience that you can bounce things off of, get their perspective on things. Even, it's always nice to have people to vent to when things are frustrating so you can kind of work out those frustrations not in that public sphere.

I think that that's a really healthy thing to be doing as well. And then I think taking the pulse of how the things you're doing are playing out, asking people that you respect How your posts or the things that you're talking about or the way you're trying to have the conversation, if it's resonating with them, if they have any feedback for you so that you can continue to sort of iterate and make sure that you're putting yourself out the there, the way that you hope you are. I think those are all strategies that can make you more successful.

Michelle Holden: That's a really great last point there, taking the pulse, sort of asking for feedback. I don't think we do that enough, especially when it comes to social media and online. I think that's something that is definitely a very great piece of advice. So thank you for sharing that.

You mentioned recently a Toronto Star article on one of your feeds talking about how Twitter's become sort of crowded with people who really do their own scientific research and use it sort of to align with their views. Do you see a future for healthcare community on Twitter with all that's changed over the last year?

Dr. Katharine Smart: I do. I think it's inevitable. Social media is sort of our new town square. It's where most people are getting their information. It's where there's a ton of dialogue. So I don't think it's going away. I think the challenge that we're having is how to make that space more nuanced. How to have it be actual dialogue and conversation versus just who can yell the loudest or be the most polarizing.

And I think that that challenge that's happening on social media just reflects the challenge that we're seeing in our own democracy. Right? We're struggling with that broadly I think across the country as people are getting more, there's more polarization. We're struggling I think a bit to find common ground. And I think it's not surprising that something like a pandemic has been traumatizing for people.

I think who hasn't been impacted by this, it has in a lot of ways been a collective trauma. And I think when people have been through traumatic experiences, they react in different ways. And I think for a lot of people, they feel very passionately about a huge variety of things around COVID and the pandemic.

And I think sometimes that state of mind that people are in can lead to sort of bias in terms of their filter or their willingness to pivot or change their opinion or really listen to what other people are trying to say or just to recognize that a lot of these things are complicated and there's not really a yes or no answer.

And whenever you're making large scale interventions across a population, there's pluses and minuses to whatever you do. And different groups of people are going to be impacted in different ways. And I think part of our role as scientists is to remain curious, to continue to ask questions, to recognize that there's always complexity, that information changes and evolves.

But to try to maintain that respectful dialogue with each other so we can continue to learn and that we're not just yelling at each other in a what's now sort of a virtual space. And I think that's the risk. And to me, what worries me about that is I think if we want to engage the public, I think if we want to improve science communication, we want to improve the public's ability to digest scientific information and to trust experts, we have to behave in a way that's respectful to each other.

And I think that's been one of the, I'd say perhaps surprising things about the pandemic is how some of that dialogue has sort of deteriorated. And I think it's something that we all need to be mindful about in terms of what we're putting into that space.

Because I think having and maintaining the trust of the public right now is so critical as we continue to battle misinformation broadly, not only about science, but about many things. And I think that the public needs to be able to look to experts and trust that they're going to do their best to bring honest opinions forward for their consideration. And how we treat each other, I think is going to impact the way the public sees us.

Michelle Holden: And as you said, if the public can come to Twitter and really get those professionals and see what they believe and feel and the science behind it, I think that's important. So definitely good to know you're not going anywhere and that we are also staying on Twitter. So speaking of Twitter, in your bio you described yourself as having excessive passion syndrome. So can you tell us what that means to you and what are some of your passions?

Dr. Katharine Smart: Yes, for sure. So that's my own DSM diagnosis that I invented for myself because I do tend to get excessively passionate about things that I love to do. So when I sort of think about myself and my work, that's a theme that often comes to mind is when I get interested in something or something matters to me, I'm always all in.

And that's just kind of how I've am wired, I guess you could say. So it's like everything, right? It's got pros and cons. I mean, the pro of course is I'm pretty good at getting things done. I'm good at building things, I'm good at finding problems and solving them because I do deeply care about many things, particularly around healthcare and children's health. And when I see a problem, I want to solve it.

And that enthusiasm often I think can be contagious to other people and they want to get on board and be part of things. So that part of it's great. And I'm proud of that, and I think that's why I've been able to have some of the successes I've had. The downside of course, of being excessively passionate is some of the things we were just talking about.

Right? When you are really passionate, you can also be quite emotive, you can be quite fired up. And sometimes you have to be able to check that emotion and make sure you're using it positively and that you're also being rational and that you're not just always not making decisions too quickly or too emotionally based and that you can learn to kind of temper it, press pause and reflect sometimes before you speak or before you take a decision.

So I'm always sort of working on balancing that. But I think what's fun about being a passionate person is I think you just see opportunities in lots of things. And I love working with other people. I love being on a team, I love building things and that I get a lot of satisfaction from that.

So I'm feel grateful to be in the healthcare space right now because even though it's really challenging, I think there's a lot of opportunity for us to really be reconsidering how we can rebuild our healthcare system in a way that's going to be sustainable and really provide high quality care for Canadians. And being able to be part of those conversations and hopefully part of that actual evolution of the system is exciting. And that definitely sparks my EPS.

Michelle Holden: I think we can all lean into our passions a little bit and as you said, to kind of help build toward the safer healthcare system. So thank you for that. I, side note, I describe my partner as being an obsessive hobbyist, so I'm going to take your diagnosis and apply it to him. So now that he has something that's semi-formal I can give him.

Dr. Katharine Smart: Perfect. Maybe we can get it into the next DSM if we keep giving it to people.

Michelle Holden: Yes, I will help you with that. So in 2022, you were recognized as one of Canada's most powerful women through the WXN Network, Women of Courage category. We wanted to say congratulations. But also in that award you said you live your truth by being unapologetically yourself. So what did you mean by that?

Dr. Katharine Smart: Well, I think over time as you get older and march down the path of life, you kind of realize that you can either try to be someone else and try to make other people happy and constantly kind of be adjusting your personality or the way you do thigs for other people's approval. Or you can just sort of recognize that you are who you are and that's going to work great for some people and not so well for others.

And I think that's a lesson that we all have to learn, is if everyone likes you or you're all things to everyone, you're probably not really achieving a lot. So I think what I've learned over time is that I like myself, I am proud of a lot of the things I've done. I'm not a perfect person. I'm always trying to improve and grow, but when I'm just get comfortable with actually being who I am and showing up as myself, usually that works the best for me.

And what matters to me the most is always that the decisions I make are in line with the values and what's important to me, and that I can feel proud of the way I showed up in a situation. So I think when you just get comfortable with that and accept that that's what matters the most, and then you become confident in who you are and the way you want to do things, I think you end up having more success because people sense that you're authentic.

They sense that that's who you are. And they can take it or leave it. So you start finding people that kind of want to be part of your tribe, people that you align well with, and those relationships tend to be really positive and fruitful because you are aligned. So for me, I think I've just gotten more comfortable with that over time.

I think as women, that's often challenging. I think women, we struggle more in that space, but because of the way we're socialized, the cultural expectations of us, a lot of times if you're an assertive woman that's seen differently than men who are assertive.

So I think it's really important that women build each other up. I think it's important that women speak out about the importance of showing up as themselves, about being bold, about living their truth, about being themselves and not trying to make themselves small.

Because I think often that's kind of what's rewarded in our society. And I think it takes women to sort of challenge that and to build up other women so that more young women, young leaders, can feel like they don't need to change who they are. They can just lean into who they want to be, and that that can be a path to success for them.

Michelle Holden: I definitely feel a bit more fired up after listening to that. So thank you. Definitely agree on that front. I wanted to pause here and introduce my director, Philip, he's listening in and ask him if he has any questions to add to Dr. Smart.

Philip De Souza: I took lots of notes in this conversation. And one, I have a few questions. You talked about policy and ensuring that children are at the center as well. So I guess a question, this could be a, I guess a rapid fire question, but if say tomorrow you're in charge of creating policy across the country, what's one policy changer, one policy initiative you would do to support that vision you have?

Dr. Katharine Smart: I think the most important thing that we could do that would probably have the broadest impact for children is to really look at policy around eliminating childhood poverty. One in 10 Canadian children, and depending what data you look at, some data even says as high as one in five children in Canada grow up living in poverty.

And we know that poverty is one of the biggest risk factors for childhood adversity. So I think really looking at our policy around how can we make sure children are not growing up in poverty in what is such a rich country would be a game changer for children in their future.

So I would really want to understand what can we do there from a policy lens that makes sure all kids are growing up housed, fed, educated, and with parents who are being supported to be able to show up for their kids. And I think having families that aren't having to deal with the stress of poverty is a first step in that direction.

Philip De Souza: And you talked a lot about the connections you have with, teachers and hospitals and other organizations, EMS, patients, government, families, there's so many. So how do you, and maybe this is a question just completely just for you or your team who you work with, how do you maintain that focus and keep people motivated and energized to keep pushing forward to do exactly what you do day in and day out?

Dr. Katharine Smart: Well, I think it's partly it's about being mindful about who's on your team. So I'm really fortunate when I started in the Yukon the first two years I was there, I was the only pediatrician that was there regularly. And then we built the team from there. So I've been able to be really mindful about who joined me there as colleagues and really been fortunate to choose to have colleagues that shared my vision and work ethic and lens on the way we provide care to families.

And we've really been able to kind of curate that group and work together to line around our values. And it's something we check in with each other about regularly. We're really, I think, kind of overt about what we're trying to do as a program. We talk often about what's going on. So I think who you're with really matters in that type of space.

Especially when you're trying to do the work of social pediatrics like we are, you've really got to have colleagues that share that vision and want to work in that way. Because it's not always the traditional way we do medicine. So I think I've been fortunate because we've been able to sort of grow that team and as we've added people, people can see what we're doing and they can see what's kind of expected if they want to be in that space, and they're people that are fired up about it as well.

So I think that that's really been helpful. And I think the other thing that really is helpful is when you start to see the impact of it and just the positive impact that you're having and you're getting that feedback, that's really motivating to want to keep going.

I was just in the Yukon recently doing my weekend service and I was in the community on a weekend and I was at the bakery and I ran into a couple families that I care for and people were excited to see me. And because of course I had some time away from clinical work while I was the CMA president. And just seeing families and hearing their feedback about some of the impact I'd had for them. And I thought, "Wow, this is an amazing job that I have."

And it's so incredible to have these connections with people and to hear from them how you've impacted their life. And I think just that constant gratitude about the importance of the work, but also the privilege of being in service to others and them trusting you, and in my case, trusting me with their children.

I really always try to think about that because really kind of keeps me going and it keeps me thinking about what's the next best thing to do for kids and families to make sure that we're helping them get what they need. So I think being around the right people and having gratitude for the privilege of the work we do are things that really help keep the focus on the right things.

Philip De Souza: Absolutely. And like you said, it's your passion. What advice would you have for leaders listening and how do, I liked your point about not being afraid and leaning in, would there be any advice you have for those leaders on, in 2023, some folks are making resolution to lean in more. Was there one thing that helped you or one piece of advice you can give to lean in more?

Dr. Katharine Smart: I think to me, again, it all comes down to relationships. I think when you're thinking about leaning in, I think lean in heavily to how do you build and strengthen the relationships with the people around you. I think that's the most important thing. And I think that's the currency that takes us the farthest when things are hard, when difficult decisions have to be made, when you have to be courageous about something, when you have to tell people things they maybe don't want to hear or people need to tell you things they don't want to hear.

I think when we can always fall back on having really developed those relationships and making it clear to the people that you work with and work for and with you, that you value them, I think that can take all of us a lot further. And I think sometimes this day and age, we've had to do a lot virtually. Sometimes we're bogged down in a lot of administration and bureaucracy. We sometimes I think kind of forget that at the core, relationships with other people are the only thing that enable change to happen. So we have to not lose sight of that.

Philip De Souza: As a new year, every new year comes around the corner, we just think about our past and we think about people or things that have helped us get to where we are today. And sometimes we think about our parents and we think about how we want to make them proud, but maybe lessons they've learned. And so I guess, as we start a new year now, comes to mind when you think of your parents?

Dr. Katharine Smart: Yeah, great question because I was just with my parents over Christmas, which was lovely because my parents live in Saskatchewan, so I don't always see them as much as I would like. But when I think about my parents, I think they really are the people that gave me the grounding and the things that matter to me.

My mom was a school teacher, she worked with elementary school children, so I always saw her passion for kids and their wellbeing. My dad was a small business owner in the community and he was deeply involved in the community and really cared about the place we lived. And both my parents always said to me, "Katherine, you're always happiest when you're doing something for someone else."

So I think there was really that early message around the importance of service and serving others and really reflecting on where are opportunities to make a difference. That was really part of my upbringing. And I think I've taken that lens into why I chose medicine and why I choose the type of work that I do now.

And when I'm having a bad day or I'm feeling frustrated or uncertain, I often come back to that, "Hey, you're in this amazing opportunity to serve others. What can you do that's going to be impactful? How can you use the opportunities that you've been given to have an impact?" So I think those were the lessons of my childhood and I try to carry that into my work now as a professional.

Philip De Souza: Oh, I love that you mentioned that and I think next time we should have your parents on with you too.

Dr. Katharine Smart: You should. They'd have lots to tell you about me.

Philip De Souza: Yes. I think this is a new thing, Michelle.

Michelle Holden: Yes.

Philip De Souza: For 2023, we should bring on guests with their parents.

Michelle Holden: You know what? And their kids. I would love to hear how that translates down as well, how that kind of works.

Dr. Katharine Smart: Oh my.

Michelle Holden: So that's a fun idea. We'll try that next time maybe. Dr. Smart, you can come back and join us.

Philip De Souza: Tell your parents to look out for an email for me. But no, that I love that point about service and that's such a great way to end. So I'll pass it back to Michelle.

Michelle Holden: That is a great way to end. We are moving, not that this wasn't fun, but to a fun version of the show, a part of the show. It's called The Lightning Round. So I'm going to ask you a few short questions and you just tell us the first thing that comes to mind.

Dr. Katharine Smart: Okay.

Michelle Holden: So what's one thing you are reading or watching right now?

Dr. Katharine Smart: I am reading Women who Run with the Wolves. So this is an interesting book about all different stories of different archetypes of different types of women. So I'm enjoying that.

Michelle Holden: If you had to deliver a 40-minute presentation without preparation on anything, what topic would you choose?

Dr. Katharine Smart: Lip syncing.

Michelle Holden: Oh yeah. Why?

Dr. Katharine Smart: I love lip syncing and I feel that if I had 40 minutes I could involve some interpretive dance, some examples, lessons learned over the years as a lip syncer. I think it could be engaging for the audience.

Michelle Holden: I would listen to that. When you were little, what did you want to do when you grew up?

Dr. Katharine Smart: Oh, so many things. At one point I wanted to be an international lawyer. I don't think I actually knew what that was. I'm not even sure that is a thing, but it sounded important. So I had that idea. And then I also had a phase where I wanted to be the prime minister, so.

Michelle Holden: Oh, very, very formal. What's one thing you would like to start doing in 2023?

Dr. Katharine Smart: Oh, good question. I would like to start a hobby. I am very bad. I don't actually really have a hobby, so I need to find a hobby and actually spend time doing it.

Michelle Holden: Not lip syncing, I guess, a different hobby.

Dr. Katharine Smart: That's true. I guess, I could consider that a hobby, but yes, something more calming.

Michelle Holden: Okay.

Dr. Katharine Smart: Maybe something artistic.

Michelle Holden: What's one thing you'd like to stop doing this year?

Dr. Katharine Smart: Oh, scrolling mindlessly on Facebook and Instagram. I need to do that less.

Michelle Holden: I said, actually Philip and the team and I were talking about this and I said scrolling was one of my big ones too. So if you find any tips that work, let me know.

Dr. Katharine Smart: I will.

Michelle Holden: If you could go back in time to any point in history, near or far, where would you want to land and why?

Dr. Katharine Smart: Oh, that's a good one. You know what? I would love to have met Nelson Mandela. I had the opportunity to, as I mentioned before, to work in South Africa twice as a medical student, and I got to go to Robin Island and see where he was in prison. And I've just have always found him such an inspiring, inspirational, motivating, incredible human.

And I would've loved the opportunity when he was being released from jail and really changing the whole trajectory of that country, just to sit down with him and hear a bit from him, his reflections. Because I think he's just really an incredible person in our time and there's not a lot of people I don't think that could have been through what he did or he went through it and have come out with his perspective. So I would've loved to have just heard about that directly from him.

Michelle Holden: That's a great answer. So you mentioned South Africa and kind of living there, it brought me to travel. So where's one place you want to travel this year that you haven't been?

Dr. Katharine Smart: Oh, that's a good question too. I love Europe. An I've been to a few countries in Europe, but there's a few places I haven't been yet, and one of the places I really would love to go is the Czech Republic.

Michelle Holden: Oh yeah, I haven't been there either, so we'll look forward to your travel tips. Last question is to tell us about your perfect day.

Dr. Katharine Smart: My perfect day would probably be a whole mix of exciting things. So sitting down. Well, let's maybe start with brunch at a nice restaurant, then meeting with a team and sort of plotting something. So maybe it's going to be like, "Hey, how are we going to fix the healthcare system?"

And getting in a room with lots of really motivated, smart people from a whole variety of backgrounds and thoughts, including patients, and just spending that next eight hours really just hashing out some incredible ideas and learning and hearing from people and getting jazzed up and fired up about that. And then going out for a nice dinner with those same people to sort of laugh and reflect on what we achieved that day.

Michelle Holden: That sounds like a busy day, but it sounds very rewarding. So we are glad that that's one of your favorite days. With that, I will let you get back to what I imagine is going to be a pretty busy day as well today. But thank you so much Dr. Smart, for sitting down with us and I hope that we will have a chance to connect again soon.

Dr. Katharine Smart: Thank you both so much. I appreciate the invitation.

Thank you for listening. You can hear more episodes of Healthcare Change Makers on our website HIROC.com and on your favourite podcasting apps. If you like what you hear, please rate us or post a review. Healthcare Change Makers is recorded by HIROC's Communications and Marketing team and produced by Podfly Productions. Follow us on Twitter at @hirocgroup or email us at communications@hiroc.com. We'd love to hear from you.